San Luis Obispo County Municipal Code Ch. 6.60 Prehospital Emergency Medical Care and Transport Services

Footnotes:

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Prior history: Ords. 2093, 2132, 2453 and 2494.

As used in this chapter, the following words and phrases have been patterned after the meaning ascribed in the National Association of EMS Physicians (NAEMSP) Medical Director's Handbook, hereafter referred to as the "NAEMSP glossary." In particular, the following terms shall have the following meaning:

"Ambulance" means a vehicle certified by the California Highway Patrol or other applicable state authorities as meeting specifications for transporting and caring for patients. This term generally refers to a wheeled vehicle, but may include boats, planes, helicopters and other specialized vehicles. A type I ambulance consists of a truck cab-chassis with a modular body that allows for replacement of the chassis and reuse of the modular body. A type II ambulance consists of a standard van-forward control-integral cab-body unit. A type III ambulance is a specialty van with forward control and usually with the ability to walk through from front.

"Ambulance service area" means those ambulance service areas established within the county and designated in individual county ambulance service provider agreements.

"Ambulance service provider" means any private or public entity or person operating, owning or controlling one or more ambulances, in a contractual agreement with the County of San Luis Obispo.

"Board" means the board of supervisors of the county.

"Central dispatch" means the San Luis Obispo County medical communication system (MED-COM) dispatch point.

"County" means the County of San Luis Obispo.

"Dispatch time" means the interval from when a request for an ambulance is received by central dispatch until the ambulance is notified.

"Emergency call" means a request for assistance that activates the EMS system. It may come through a variety of mechanisms: Voice, regular telephone, 911 or radio.

"Emergency rescue vehicle" means any privately or publicly owned motor vehicle, boat, aircraft, that is specially constructed, modified, equipped or arranged, and operated, that would aid in life saving activities in the event of a sudden, generally unexpected occurrence demanding immediate action.

"EMT-D" means emergency medical technician-defibrillator; an EMT-I with additional training to perform cardiac defibrillation on unconscious, pulseless and anemic patients, as defined by 22 California Code of Regulations Section 100064.

"EMT-I" means an emergency medical technician I as defined in Health and Safety Code Section 1797.80 and 22 California Code of Regulations Section 100063.

"EMT-P" means emergency medical technician-paramedic; an EMT-A with additional training to the full advanced life support level, as defined in Health and Safety Code Section 1797.84 and 22 California Code of Regulations Section 100138.

"First responder" means the first individual to arrive at the scene certified to render medical care in response to an emergency call.

"Local EMS agency" means the county health department.

"MED-COM" means the radio, telephone and dispatch system equipment that makes up the San Luis Obispo County medical communications system.

"Patient" means a wounded, injured, sick, invalid, convalescent, infirm or otherwise incapacitated person requiring immediate medical attention and/or presenting a significant probability of requiring medical care while being transported, as judged by the most highly medically qualified person at the scene.

"Remote area" means areas of the county which have a population density of nine persons or less per square mile.

Response code:

(1) "Code I" means an ambulance is to arrive at its destination at the earliest convenience.

(2) "Code II" means an ambulance is to proceed to its destination as rapidly as possible, obeying traffic laws.

(3) "Code III" means an ambulance is authorized to use a red warning light and siren.

"Response time" means the interval of time from ambulance notification until the ambulance is at the scene.

"Rural area" means all definable community areas of the county with a population of less than two thousand five hundred and population density of ten to ninety nine persons per square mile.

"Urban area" means all definable community areas of the county with a population of two thousand five hundred to five hundred thousand and a population density of one hundred or more persons per square mile.

(Ord. 2629 § 1 (part), 1993)

No individual, partnership, corporation or other entity shall operate, conduct, advertise or otherwise be engaged in the business or service of the transportation of patients upon the street, or any public way or place within the county, unless the county, through the board of supervisors, has executed a written county ambulance service provider agreement with the individual, partnership, corporation, or other entity. An ambulance operated by an agency of the United States or by the state shall not be required to have such an agreement.

(1) The county ambulance service provider agreements with private providers shall provide for some method of ensuring that in the event the provider ceases to perform the agreement for any reason (including insolvency, bankruptcy, voluntary or involuntary dissolution of the business) the ambulances and operating equipment used by the provider in carrying out the agreement will be available for use by the county, or another private provider operating under agreement with the county, free of any legal encumbrances. The provisions may take the form of county ownership with lease-back arrangements or some other method, as recommended by the ambulance performance/operations committee.

(2) The agreements shall address other areas of operation and performance, including, but not limited to, coverage requirements, minimum response time standards, staffing and certification requirements, review of financial and other records, data collection and reporting requirements, system interaction and rates.

(3) The agreements will be developed by the ambulance operations/performance review committee before submission to the board of supervisors for approval on behalf of the county.

(4) During the term of any agreement, proponents of any additional provider service in any of the assigned ambulance service areas shall have the burden of demonstrating that the public health, safety and welfare require the additional service.

(Ord. 2629 § 1 (part), 1993)

An ambulance operations/performance committee is created, to be organized as follows for the purposes set forth as follows:

(1) The ambulance operations/performance committee shall consist of seven members, three who shall be appointed by the county administrator, and four who shall be appointed by the city managers, of which at least two shall be fire chiefs. The committee members appointed by the city managers shall each be approved by a majority of the city managers of the incorporated cities located within the county. None of the members shall be employees, officers, agents or owners of any of the private ambulance service providers. The members shall serve indefinite terms at the discretion of their appointing authority. The committee will be assisted in certain clerical functions by the County of San Luis Obispo.

(2) The purpose of the ambulance operations/performance committee is to assist the county board of supervisors in developing and administering policy on all aspects of the prehospital emergency medical services system including, but not limited to, the following:

a. The service levels and response capabilities of ambulance providers in the county;

b. The development and oversight of contractual relationships between the county and ambulance service providers;

c. The development and oversight of agreements between the cities of San Luis Obispo County and the County of San Luis Obispo;

d. The rate structure of ambulance providers, and the services and financing of EMS first responder agencies;

e. The development and maintenance of ambulance performance standards;

f. The development and oversight of ambulance service areas.

(3) The ambulance performance/operations committee may develop such bylaws as it determines necessary for the performance of its duties as outlined herein. Bylaws, once determined, shall be referred to the board of supervisors for its consideration and approval.

(Ord. 2629 § 1 (part) 1993)

(a) Any ambulance service provider which operates within the unincorporated territory of the county shall not charge any rate until that rate has first been approved by the board of supervisors through inclusion of the rates in provider agreements approved by the county.

(b) All county ambulance service providers doing business within the unincorporated territory of the county shall maintain a schedule of their current rates in each ambulance that they operate.

(c) This section shall not apply to services provided by any public entity responding within that public entity's jurisdictional boundary.

(Ord. 2629 § 1 (part), 1993)

As required by Title 13 of the California Code of Regulations Section 1106.2, no owner shall use any ambulance, or permit any ambulance to be used, to transport passengers for hire without maintaining the ability to respond in damages as required by Vehicle Code Section 16500.

(Ord. 2629 § 1 (part), 1993)